HomeMy WebLinkAboutFILLED LAND AFFIDAVITREC �v, L
MAR 18 201E
PERMMI'ING
St. Lucie County, FL
ST. LUCIE COUNTY
BUILDING & ZONING SCANNED2300 VIRGINN IA AVEUE
FORT PIERCE, FL 34982-5652 BY
772-462-1553 Sty udeFaouniv
FILLED LANDS AFFIDAVIT
I I, the undersigned, am the owner of the following described property�VVm\GS—N-_'z lz�v�P'
;)#1301 111 nnnl nnn 5 East 1- of Sentinn 1 to urchin 44S Range 39E,
(Ta rD/Legaldescnpuon/Address)lying N&W of Turnpike FeedE
for which I have applied to St. Lucie County for a Final Development
this Final Development Permit, BP Number I acknowl
the above described property, and in accordance with Section 7.04.011
Land Development Code, I shall be responsible for assuring adequab
immediate community WILL NOT be adversely affected. I furthe
granting this permit for the development of this property, St. Lucie C t
nor liable to provide for, or maintain in any form, adequate drainag o
will not adversely affect the immediate community. n
Property Owner Name
STATE OF FLORIDA. COUNTY OF S t T 1In l P
Permit. In accepting
;dge that as owner of
D), St. Lucie County
drainage so that the
acknowledge that in
my is neither Obliged
f my property which
Date
ACKNOWLEDGED BEFORE ME THIS DAY OF IV AX C hi .20
BY /YIR-lriieCYCC &VIVO WHO IS PERSONALLY KNOWNTO ME OR WHO HAS PRODUCED
SIGNATURE OF NOVARY
NOTARY PUBLIC TITLE
]IDENTIFICATION.
UO2o'�y %trN !JA-SKIS
TYPE OR PRINT NAME OF NOTARY
COMMISSION NUMBER
Notary Public - state
My Comm. EaWlee 0
Commiaeloo 0 FF
(SEAL)